Provider Demographics
NPI:1184919706
Name:CORTES, MARGARET ROXANNA (MS/LIC-SLP)
Entity type:Individual
Prefix:MRS
First Name:MARGARET
Middle Name:ROXANNA
Last Name:CORTES
Suffix:
Gender:F
Credentials:MS/LIC-SLP
Other - Prefix:MS
Other - First Name:MARGARET
Other - Middle Name:ROXANNA
Other - Last Name:GOMEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS-SLP/L
Mailing Address - Street 1:11710 S AVENUE J
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60617-7428
Mailing Address - Country:US
Mailing Address - Phone:773-557-8729
Mailing Address - Fax:773-530-7435
Practice Address - Street 1:11710 S AVENUE J
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60617-7428
Practice Address - Country:US
Practice Address - Phone:773-557-8729
Practice Address - Fax:773-530-7435
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-10
Last Update Date:2014-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146.008498235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist